Evaluating Treatments for Ménière's Disease: Controversies Surrounding Placebo Control

Hamill, Teri

doi:10.3766/jaaa.17.1.4

Cited by 10 publications

(3 citation statements)

References 28 publications

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“…Separation of the effect of treatment from the cyclical natural history of the disorder poses difficulties for all studies of Meniere’s disease. Because the natural history is one of remission and recurrence, and because participants must have active vertigo to enrol in a study, spontaneous improvement through regression to the mean in terms of symptom frequency and severity is expected, creating the illusion of a therapeutic efficacy 6162 Thus, a control group is vital to contrast the long term treatment effect against spontaneous improvement.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of betahistine treatment in patients with Meniere’s disease: primary results of a long term, multicentre, double blind, randomised, placebo controlled, dose defining trial (BEMED trial)

Adrion

Fischer

Wagner

et al. 2016

BMJ

148

126

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show abstract

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of betahistine treatment in patients with Meniere’s disease: primary results of a long term, multicentre, double blind, randomised, placebo controlled, dose defining trial (BEMED trial)

Adrion

Fischer

Wagner

et al. 2016

BMJ

148

126

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show abstract

“…Moreover, vertigo attacks recurred in all 77 patients. This result was likely due to 4 possible causes: (I) The change of clinical symptoms in these patients may have been a coincidence related to normal symptom fluctuation ( 21 , 27 ). (II) An acute increase in the endolymphatic space which was too small to be shown by MRI caused the vestibular disorder ( 28 , 29 ).…”

Section: Discussionmentioning

confidence: 95%

Longitudinal variation of endolymphatic hydrops in patients with Ménière’s disease

Li¹,

Wang²,

Hu³

et al. 2023

Ann Transl Med

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Background: The relationships of endolymphatic hydrops (EH) and perilymphatic enhancement (PE) with Ménière's disease (MD) remains unclear. This study aimed to describe the dynamic variation of EH and PE for MD patients over 2 hospitalizations by applying magnetic resonance imaging (MRI) to further clarify the relationships of EH and PE with MD.Methods: A total of 77 MD patients who underwent inner ear MRI after intravenous administration of gadolinium and pure-tone average (PTA) testing during a first and second hospitalization were included.The degree of EH and PE were evaluated via MRI, and the duration and frequency of vertigo attacks and PTA were collected and recorded. The PTA, EH, and PE for the 2 hospitalizations were compared, and the relationships of EH and cochlear PE with the MD stage were investigated.Results: There was no difference between the 2 hospitalizations for duration of vertigo attacks or frequency of vertigo attacks. However, there were significant differences in PTA (Z=−3.02, P=0.003). Additionally, the cochlear and vestibular EH in the asymptomatic ear at the second hospitalization was significantly worse than that of the first hospitalization (Z=−2.33 and −2.49, P=0.020 and 0.013, respectively), while there were no differences in EH and PE in the affected ear (all P>0.05). Moreover, the degree of cochlear and vestibular EH was correlated with MD stage (both P<0.01).Conclusions: Although EH and PE in the affected ear were unchanged over 2 hospitalizations, an underlying EH in the asymptomatic ear and hearing loss in the affected ear for MD patients developed longitudinally with the duration of disease, and EH varied with the natural course of MD whereas PE did not. Therefore, EH instead of PE is necessary but insufficient to cause the clinical symptoms of MD.

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“…Due to natural course of the disease, vertigo attacks of 60-80% of patients improve without any intervention [56,57]. Patients who refused to take any medical or surgical assistance had spontaneous improvement of their symptoms at the rate of 71% [43].…”

Section: Treatmentmentioning

confidence: 99%

Meniere’s Disease: Nonsurgical Treatment

Yılmaz¹,

Yılmaz²,

Batıoğlu-Karaaltın³

2019

Meniere's Disease [Working Title]

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Meniere's disease or syndrome is one of the most common inner ear diseases. Meniere's disease is characterized by episodic vertigo, sensorineural hearing loss that fluctuates during episodes, tinnitus, and ear fullness. Ideal treatment should stop vertigo attacks, restore hearing, get rid of tinnitus and ear fullness. Treatment options are decided upon the remaining hearing, severity, and intensity of vertigo attacks. Meniere's disease is progressive on hearing levels of the patient; some of them develop profound hearing loss that also could affect the other ear. In order to plan a treatment scheme for patient, these conditions should be assessed. It has a destructive and progressive nature, so the first step of treatment should contain more conservative treatment options. If symptom control could not be obtained, destructive treatment options should be considered.

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Evaluating Treatments for Ménière's Disease: Controversies Surrounding Placebo Control

Cited by 10 publications

References 28 publications

Efficacy and safety of betahistine treatment in patients with Meniere’s disease: primary results of a long term, multicentre, double blind, randomised, placebo controlled, dose defining trial (BEMED trial)

Efficacy and safety of betahistine treatment in patients with Meniere’s disease: primary results of a long term, multicentre, double blind, randomised, placebo controlled, dose defining trial (BEMED trial)

Longitudinal variation of endolymphatic hydrops in patients with Ménière’s disease

Meniere’s Disease: Nonsurgical Treatment

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